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Promotion criteria: perceptions of faculty members and departmental chairmen.

Medical school promotions committees tend to depend heavily on departmental evaluations of candidates for promotion. Unfortunately, departments often lack clear promotion guidelines; this results in confused perceptions of promotion criteria. Faculty members and department chairman do not always see eye to eye. When asked to indicate which activities contributed the most toward achieving promotion to higher academic rank, faculty members in a large midwestern medical school perceived research to be the single most important activity. Departmental chairmen had a broader perception, however, and included research, teaching patient care and administration/service in their list of desirable and essential activities. Faculty members and chairman differed significantly (p less than .01) in their mean ratings of 12 of 69 activities. Such perceptual discrepancies can lead to conflict and disagreement that can be avoided by straightforward explanations of promotion criteria and more clearly defined job descriptions and time allocations.

Clinical Competence↗

Job content and pharmacists' job attitudes.

The relationships between job content and hospital pharmacists' work attitudes are examined. A 152-item questionnaire was mailed to 507 hospital pharmacists in southeastern Michigan. The questionnaire included measures of job dimensions, psychological states, and personal and work outcomes. Mean scores for 34 subscales consisting of 2-5 related items were computed. Background characteristics were also assessed. Using factor analysis, the respondents were categorized as clinical, inpatient, outpatient, or generalists depending on their reported relative time spent performing 23 nonadministrative job functions. Analysis of variance was performed across the four groups for each subscale; the level of significance was set at 0.001. The response rate was 56%, representing 283 completed questionnaires. The clinical, outpatient, inpatient, and generalist pharmacist groups consisted of 43, 36, 70, and 134 respondents, respectively. There was a prevalent trend in the rank order in which pharmacists in the four groups responded to various subscales. The clinical group had the highest scores for 13 of the 14 subscales that were significantly different across pharmacist groups. Alternatively, in all but one of the significantly different subscales the inpatient group ranked lowest. Because pharmacists in the clinical group consistently scored higher than the other groups on scales measuring components of job enrichment, the authors concluded that the challenge of hospital pharmacy managers is to adapt the positive features of clinical practice to other areas of the profession.

Attitude of Health Personnel↗

Pharmacy-coordinated investigational drug services.

The concept of a pharmacy-coordinated investigational drug service (IDS) is proposed as an approach to better control of investigational drugs. The IDS should be considered as set of service functions aimed to ensure that investigational drug studies in the hospital are executed in a safe, effective, and efficient manner. These functions are the distribution and control of study drugs, clinical services, research activities, and management of clinical studies. The IDS will vary from hospital to hospital, and should reflect the extent to which the institution is involved with research, available resources, and the needs of the hospital. Successful development and operation of an IDS depend on proper planning and continued effective management. The IDS will require resources of personnel, money, and facilities, space, and equipment. The primary expense of the IDS (probably about 80%) will be personnel. Job descriptions for each staff position should be prepared, and a complete set of standard operating policies and procedures is required. Periodic reports summarizing the activities of the IDS and an ongoing quality assurance program are needed. To create an IDS, the pharmacy must acquire the necessary approvals, authority, and resources. The IDS will benefit patients, nursing staff, clinical investigators, hospital risk management, and sponsors of clinical research. These benefits can be used to gain support for the IDS concept. Once the IDS is established, the best promotion will be a successful track of accomplishing the IDS objectives.

Clinical Trials as Topic↗

A minority recruitment and retention model for a Department of Medical Allied Health Professions.

A model for the recruitment and retention of minority students for a department of medical allied health professionals has been developed. The model includes four major components: recruitment, admissions, support systems, and career realization. Suggestions for implementation and coordination of model activities revolve around the services of a minority student advocate whose job description is provided. Specific criteria for evaluation and the time table for implementation of the model are suggested. The model has implications for improving the potential for a positive experience for minority allied health students who apply to and enroll in majority campuses of higher education.

Allied Health Personnel↗

Paper chase: does academic degree make a difference?

The purpose of this study was to examine the employment related differences between graduates of baccalaureate and associate degree programs in allied health education. Specifically, graduates were compared with respect to the level of professional responsibility, salary, geographic mobility, and job satisfaction. Data regarding a job placement of radiologic technologists from a baccalaureate program are reported.

Allied Health Personnel↗

Job satisfaction among hospital nurses: a longitudinal study.

Data from a two-wave panel study of staff nurses in two hospitals are used to assess the relative importance of several types of independent variables as determinants of job satisfaction. Both organizational and nonorganizational determinants are examined, with the formed including both perceptual and structural measures. Job satisfaction is measured in two ways using both Overall and Multi-Facet indicators. The independent variables were measured five months before the dependent variables were measured in order to attenuate contamination problems. Findings indicate that perceptions of job and nursing unit attributes, particularly autonomy and task delegation, predict satisfaction most strongly. In addition, a nurse's own characteristics are found to be more important than either structural attributes of nursing units or job characteristics in predicting job satisfaction.

Adult↗

Being a midwife.

Explore the source record for details and available documents.

Humans↗

A more cost-effective use of medical air evacuation personnel.

Air transport of severely traumatized patients has evolved from novel pilot programs into integral services provided by tertiary care health centers. Medical air evacuation (MedEvac) effectiveness is mainly due to the rapid transport of critically injured (90% blunt trauma) patients to the hospital by highly trained medical personnel. A recent self-study of a University-based MedEvac crew showed that 67 per cent of their on-duty time was "available." Only 33 per cent of duty time was flying or related patient care. In this era of cost containment, the optimal use of materials and services must be reassessed. The most cost-effective use of the crew may require expanding the role of the MedEvac to include Emergency Department responsibilities as part of the job description. This represents change and stressful group dynamics. However, by coordinating the Emergency Department and MedEvac schedules, the hospital is able to make more efficient use of resources. No flight was delayed by this work proposal.

Aircraft↗

The challenging experience of palliative care support-team nursing.

The purpose of this study was to document the experience of palliative care nursing as a part of a multidisciplinary support team. Data were obtained from two palliative care support-team nurses. Each nurse privately recorded on audiotape any reflections about particularly meaningful aspects of her daily work experience; in-depth interviews with the two nurses together also were used for data collection. Inductive analysis elicited previously identified dimensions of palliative care nursing, including the support and coordination functions provided to other health professionals. The palliative care support-team experience included many challenges associated with the ultimate outcome of death; restricted and unpredictable time frames; and greater demands for human resources, psychosocial-care skills, and interdisciplinary, family-oriented care. These factors appeared to interact with the nurses' commitment by escalating their drive to serve others and creating both internal and external conflicts. The nurses expended considerable energy in role adaptation and in intrapersonal and interprofessional conflict management. This effort emerged as being vital to the nurses preserving their own integrity, both personally and professionally. The findings of this study may help all professionals who provide palliative care to better understand the nature of their work, themselves, and each other. Strategies to promote understanding may help to reduce the amount of time and energy that professionals must dedicate to preservation of integrity.

Adaptation, Psychological↗

Identifying nurses vulnerable to role conflict.

To remedy the nursing shortage in the US, hospitals initially focused on expensive recruitment efforts to fill nursing vacancies. Few addressed a core component of the problem: role conflict, which when reduced can be instrumental in hospitals attracting and retaining nurses.

Adult↗

The trouble with 'quality'.

Much like that elusive but sought-after commodity, beauty, quality lies to a great extent in the eye and mind of its beholder. Whilst some are content with second-hand goods, others insist that only the best will do, the judgement of what is the best being a very individual phenomenon. The mechanical aspects of quality are those things which are visible or tactile: cleanliness, completeness, adequate numbers, smiling faces, quickly answered phones. All of these may be visible and present in a unit which offers a poor quality service. Behind the smiling faces, the efficiently answered phone, may lie a philosophy of total self-centredness, a value system based on clock watching and working strictly within a job description. This person may never give that important small sacrifice which puts another's needs ahead of their own.

Efficiency, Organizational↗

Putting prevention into practice.

In primary medical care settings, disease prevention services are delivered at lower rates than recommended. Furthermore, practitioners tend to overestimate the rate at which they perform them. There are essentially two steps in delivering evidence-based preventive services: (1) knowing what the evidence is for performing various detection and intervention manoeuvres, and (2) integrating the preventive services into daily practice. The first is a scientific process and is carried out in Canada by the Canadian Task Force on the Periodic Health Examination. However, after a decade of experience with evidence-based guidelines, we now know that guidelines are not enough. Integrating clinical prevention into busy practices is a political and logistical process. This truth is best captured by the quip, "An ounce of prevention requires a pound of office system change". A number of studies have demonstrated that continuing medical education (CME) courses and workshops for physicians are not enough to ensure that clinical preventive services are incorporated into practice. According to Lomas, the traditional CME educational approaches need to be complemented by strategies from such paradigms as the social influence model, the diffusion of innovation model and the adult learning model. Battista, in "From Science to Practice," points out the complexity of the communication process required for the diffusion of innovation into practice. Walsh's Systems Model of Clinical Preventive care best captures the interacting factors that mediate between practitioners' intentions and their actions when it comes to delivering clinical prevention services. This paper reports on a practical example of helping family practitioners develop a "sustaining office system in prevention" that minimizes barriers, focuses energy and integrates clinical prevention into office routines. The key components are (i) a practice coordinator for prevention, (ii) clear clinical prevention-related job descriptions for all persons who deal with patients, (iii) an information management system that reinforces prevention, and (iv) a practice feedback and problem solving strategy.

Aged↗

Non-nursing functions: time for them to go.

While evaluating a professional practice model, serendipitous findings emerged from the data regarding non-nursing functions. Performing non-nursing functions and attitudes about doing so were significantly related to management data.

Attitude of Health Personnel↗